Contact Stomatitis

Updated: Oct 07, 2015
  • Author: Antonella Tosti, MD; Chief Editor: Dirk M Elston, MD  more...
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Overview

Background

Contact stomatitis describes an inflammatory reaction of the oral mucosa by contact with irritants or allergens (see the images below). Contact stomatitis is classified by its clinical features, pattern of distribution, or etiologic factors. Contact stomatitis frequently goes undetected because of the scarcity of clinical signs that are often less pronounced than subjective symptoms.

Irritant contact stomatitis of the tongue. Irritant contact stomatitis of the tongue.
Close-up view of irritant contact stomatitis of th Close-up view of irritant contact stomatitis of the tongue.
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Pathophysiology

The oral mucosa is relatively resistant to irritants and allergens due to the following anatomical and physiological factors:

  • High vascularization that favors absorption and prevents prolonged contact with allergens
  • Low density of Langerhans cells and T lymphocytes
  • Dilution of irritants and allergens by saliva that also buffers alkaline compounds
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Epidemiology

Frequency

United States

The exact incidence of contact stomatitis is unknown; however, numerous well-documented series of patients with this disorder are described in the literature. Irritant reactions appear to be more common than allergic reactions.

International

In Europe, an estimated 0.01% of the population has oral symptoms related to dental materials. [1] Patch testing identifies a contact allergy in no more than 10% of these patients. Allergic reactions are usually intraoral (68%), and responsible materials are more commonly latex, metals, resins, and hygiene products. Patients with oral mucosal diseases are significantly more likely to have demonstrable hypersensitivity to food additives, especially benzoic acid, and perfumes and flavorings, especially cinnamaldehyde, compared with controls. [2]

Sex

No sexual predilection is known for contact stomatitis, except for the burning mouth syndrome that almost exclusively affects women.

Age

Contact stomatitis may occur in persons of any age, but it is much more common in elderly individuals. A study evaluating oral lesions among elderly people revealed denture-induced stomatitis in 17.2% of patients aged 65-99 years. [3] Allergic contact stomatitis to nickel seems to be more frequent in young females with a clinical history of allergies; it is not associated with how long the patients are exposed to fixed orthodontic appliances.

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